Motivational Interviewing Helps Vets Get Treatment

During the last decade, motivational interviewing has been found to help individuals break substance abuse addictions, stay on diets, and improve overall health and well-being.

A new study finds that the technique facilitates traditional psychotherapy for Iraq and Afghanistan war veterans.

In the study, researchers determined the brief intervention, delivered over the phone, was significantly more effective than a simple “check-in” call in getting Iraq and Afghanistan war veterans with mental health diagnoses to begin treatment for their conditions.

Researchers also found that participants receiving telephone motivational interviewing were significantly more likely to stay in therapy, and reported reductions in marijuana use and a decreased sense of stigma associated with mental health treatment.

The study is published online in the journal General Hospital Psychiatry (May 25, 2012).

Lead author Karen Seal, M.D., M.P.H., noted that 52 percent of the approximately half-million Iraq and Afghanistan veterans currently being seen by the VA have one or more mental health diagnoses, including post-traumatic stress disorder, depression, anxiety or other related conditions.

“The VA has gone to extraordinary lengths to provide these veterans with state-of-the-art, evidence-based mental health treatment,” she said. “The irony is that they are not necessarily engaging in this treatment. This study was positioned to try to connect our veterans with the treatments that are available to them.”

Motivational interviewing is a technique that encourages clients to explore and articulate discrepancies between their core values and their actual behaviors.

“Articulating to the counselor how they want to change can motivate someone to make actual behavioral changes, such as engaging in treatment,” said Seal. “The counselor then supports the client’s perception that they can actually make these changes.”

In the study, 73 veterans of the Iraq and Afghanistan wars who screened positive for one or more mental health diagnoses were randomly assigned either to a group that received four motivational interviewing sessions or a control group that received four neutral check-in sessions over a period of eight weeks.

“We thought that using the telephone to conduct this intervention would be a really good idea because these veterans are young, they’re busy, they’re in school, they have families and they all carry cell phones,” Seal said.

By the end of the study, 62 percent of the motivational interviewing group had begun treatment, versus 26 percent of the control group.

Researchers also found that the motivational interviewing group was significantly more likely to stay in treatment, and also reported significantly decreased marijuana use and significantly less sense of stigma associated with mental health treatment than the control group.

The counselors who conducted the study intervention were not licensed clinicians, but “qualified people with masters’ degrees who were trained for about eight hours,” said Seal. “This means that the expense for personnel will not need to be huge if this becomes a routine procedure.”

Seal emphasized that the study was a first-time pilot trial designed to assess the potential efficacy of telephone motivational interviewing, and that more research is needed to test the technique among larger groups of veterans.

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About Rick Nauert PhD

Dr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.